Targeting uninsured Hispanics for ACA enrollment

MIAMI (AP) — After a shaky rollout, enrollment in the federal health insurance marketplace is climbing with more than 1 million nationwide and nearly 18,000 in Florida. Yet anecdotal evidence suggests Latinos could be lagging their peers because of confusion about subsidies, cumbersome requirements for naturalization documents and fear they could unwittingly identify relatives in the country illegally.

Federal health officials have not said how many of Florida’s nearly 18,000 enrollees from October and November were Hispanic, but enrollment counselors say they fear signups from that community are low.

Yuraldi Baamonde, a 40-year-old mechanic from Miami, is one of an estimated 1.3 million Hispanic Floridians who lack health insurance, according to the Kaiser Family Foundation, a nonprofit that studies health care issues. Hispanics account for about one-third of the roughly 3.5 million uninsured people in Florida.

Baamonde and his 35-year-old wife tried to enroll in a health plan with help from a counselor Wednesday.

An hour into the process, their application was stalled because federal health officials needed to verify information. Baamonde was not frustrated by the wait, saying “the process is normal” and that he was eager to have coverage that he could afford.

Navigator Juanita Mainster said the federal government’s website frequently asks for residency and naturalization papers from Hispanic applicants, which can stall the process for weeks if they are mailed in.

For the many Latino applicants who come from countries where government health care is free, it’s been difficult to understand premiums, deductibles and co-pays. Maria Jimenez, a navigator for the Hispanic Services Council in Tampa, says many assume they automatically qualify.

“They believe it’s government insurance like Medicaid,” she said.

The Latino community also wants someone to walk them step by step through the enrollment process, said Steven Lopez, senior health policy analyst with the National Council of La Raza, a leading Latino advocacy group.

“We know there’s a finite number of resources. There’s not enough navigators for the number of people who want that direct assistance,” he said.

Language is a barrier for some. Nationally, only 4 percent of calls to a government call center were Spanish-only calls, as of Dec. 10.

Florida isn’t spending any additional money on marketing and outreach and is relying on $5.8 million federal grant to fund navigators around the state.

The Epilepsy Foundation of Florida, which received a federal grant, is adding two more Spanish speaking staffers. The group, which is headquartered in Miami, has been flooded with Hispanics seeking in-person assistance.

However, navigators there estimated only about 30 percent of their Hispanic applicants end up enrolling in a plan. That’s because many people fall into a gap where they make slightly too much money to qualify for Medicaid, yet are still below the poverty level so they don’t qualify for tax credits for Affordable Care Act insurance.

Federal health officials anticipate roughly 1 million Floridians fall into that gap because the Republican-led Legislature decided not to expand Medicaid.

Some Latinos also worry they’ll inadvertently give information through the application process that could get someone in their home deported. An estimated 481,000 undocumented Floridians — which also includes non-Latino immigrants — are not eligible for coverage through the federal exchange, according to Kaiser. But many households include members of varied immigration status.

The Obama administration has repeatedly said health care application information will not be used for immigration enforcement. Many navigators have printed a memo issued by U.S. Immigration and Customs Enforcement to show skeptical applicants when they enroll, in addition to verbally explaining it.

“We’re trying to communicate it many times and communicate it from different fronts… after a while people begin to reduce the level of fear and misgiving they might have, but it is taking some time,” said Lopez. “It’s taking a few go-arounds for folks to get it and accept it.”

Univision Communications Inc., which runs the largest Spanish-language media network, has been airing daily PSAs about the new law. Spokesman Jose Zamora said the network also frequently airs segments about the new law on its weekend health shows and produced a Dec. 1 documentary featuring 19 year-old Mexican-American Luis Veloz, whose own father suffered three heart attacks with no insurance, exploring obstacles Latinos face signing up for health insurance.

After delaying CuidadoDeSalud.gov by more than two months, federal health officials said they plan to ramp up enrollment efforts among Hispanic groups later this month after they’ve worked out some of the website’s kinks. Some groups have complained of sloppy translations and say the site moves more slowly than its English counterpart.

Miami navigator Nini Hadwen used the English website to help Martha Arboleda, who only speaks Spanish, with her application because Hadwen said the English website is more reliable.

In less than an hour this week, Arboleda, a 51-year-old Miami housekeeper and Columbia native, learned she qualified for $373 in monthly tax subsidies. She didn’t immediately sign-up, but narrowed it down to three plans with premiums ranging from $27 to $92 a month.

“I’m happy,” said Arboleda, who has gone without insurance for years because she couldn’t afford it. “I know my options now and I know that I can afford them.”